Jorge Luis Palacios

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1288 N Verdugo Rd Ste a
Glendale, CA 91206-6304

Phone

(951) 264-1814

NPI assigned

Oct 30, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optima Family Services, Inc.

  • Early Intervention Provider Agency
  • Glendale, CA
  • NPI 1073829107
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1932676772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 ARLINGTON AVE APT 11",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042765",
            "telephone_number": "951-264-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 N VERDUGO RD STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912066304",
            "telephone_number": "951-264-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Amelia Painter, RD
• Pak Podiatry Corp
• Joo Chon Pak, L AC
• Myung Soon Pak, L AC
• Brian Palacios S Nchez
• Miguel Palacios Jr.
• Trevor Palacios
• Dianne K Palasio, NP
• Palermo Hospice Inc
• Odalis Palestino Mendez

• Behavior Technician in Glendale, CA
• Providers in Glendale, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.